Not all women need chemotherapy for breast cancer

Tens of thousands of women with breast cancer may now be able to skip chemotherapy.

According to a study in the New England Journal of Medicine, researchers found that women with smaller-sized tumors that have not spread to the lymph nodes — and who did not receive chemotherapy — did just as well as those who did.

"Based on the findings, women who fall into this group can now safely avoid chemotherapy because we know it doesn't make any difference on patient outcomes," says Dr. Reema Batra, a board-certified oncologist and hematologist affiliated with Sharp Grossmont Hospital. "This is exciting news and will impact the standard of care immediately."

The findings mean many women won't be exposed to tough side effects caused by chemotherapy, ranging from fatigue and hair loss to more serious harm.

While chemotherapy saves lives, it also impacts quality of life. Dr. Batra says, "There are short-term and long-term side effects. Long term, patients are at risk for acute leukemia, albeit a small risk. There are also psychosocial implications — women often have to take time off from work, income may be affected, meeting family obligations is difficult, and so on."

Health care providers also perform a common genetic test on this type of breast cancer to determine who would benefit from chemotherapy. The test examines a gene panel related to cancer recurrence and assigns a score. In the past, there's been uncertainty about patients who receive a mid-range score.

"Previously, women with a low-risk score could avoid chemotherapy, and those with a high-risk score were recommended to receive chemotherapy. Women in the intermediate group, however, were left to decide chemo or no chemo," says Dr. Batra.

"Oncologists generally would offer chemotherapy because we didn't know what the implications were for this group. Now we can safely avoid it, and have research to back it up."

Of the 250,000 women expected to be diagnosed with breast cancer in the U.S. in 2018, the findings impact about 65,000 patients.

As a leader in clinical oncology research, Sharp HealthCare participated in the study, which included more than 10,000 women between the ages of 18 and 75. "Because we're a large system and see quite a few patients with breast cancer, we had a wealth of patients that could sign up. Overall, we enrolled approximately 65 patients," says Dr. Batra.

Clinical trials offer several advantages, including access to promising new treatments not yet available in a standard of care setting. Dr. Batra says, "Patients receive medications that aren't yet approved, but have gone through enough of a research process to know that the medication could potentially work on their cancer. This is how all treatments eventually get approved."

She adds, "In this case, the women who participated changed the face of treatment and standard of care. This is a huge contribution to science and the medical world that will help tens of thousands of breast cancer patients."

For the news media: To talk with Dr. Reema Batra, board-certified oncologist and hematologist, about breast cancer or this study for an upcoming story, contact Erica Carlson, senior public relations specialist, at erica.carlson@sharp.com.